Engaging the public in healthcare decision-making: results from a Citizens’ Jury on emergency care services

Scuffham, Paul Anthony; Moretto, Nicole; Krinks, Rachael; Burton, Paul; Whitty, Jennifer A.; Wilson, Andrew; FitzGerald, Gerry; Kendall, Elizabeth

doi:10.1136/emermed-2015-205663

Cited by 13 publications

(15 citation statements)

References 12 publications

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“…Researchers are now seeking to address this issue (Scuffham et al, 2014) but it seems that the policy-level debate between a Humanities/Legal and Methodological/Health Economic approach at a national policy level described in the previous section is also being re-enacted at a research level in the field of public participation (Boaz et al, 2014;Burton et al, 2014). In a commentary on an extensive research programme comparing citizen councils and discrete choice methods to elicit public priorities and preferences in two key areas for health carethe use of emergency services and management of obesity (Harris et al, 2015(Harris et al, , 2018Scuffham et al, 2016Scuffham et al, , 2018 -Boaz refers to the argument that researchers often focus on the hardware of participation (the how to, methods, approaches, guidelines, etc.) rather than the "software" of values, norms and codes that shape scientific practice (Wilsdon et al, 2005) and goes onto suggest that all these initiatives should be viewed from a "rights" perspective.…”

Section: Public Participation As the Key To Acceptable Prioritisationmentioning

confidence: 99%

Creating sustainable health care systems

Kieslich

Weale

Tumilty

et al. 2019

JHOM

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Purpose-In order to create sustainable health systems, many countries are introducing ways to prioritise health services underpinned by a process of health technology assessment. While this approach requires technical judgements of clinical effectiveness and cost effectiveness, these are embedded in a wider set of social (societal) value judgements, including fairness, responsiveness to need, nondiscrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritisation and the resulting decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritisation process. Design/methodology/approach-Through a multidisciplinary collaboration involving a series of international workshops, ethical and political theory (including accountability for reasonableness) have been applied to develop a practical way forward through the creation of a values framework. The authors have tested this framework in England and in New Zealand using a mixed-methods approach.

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Section: Public Participation As the Key To Acceptable Prioritisationmentioning

confidence: 99%

Creating sustainable health care systems

Kieslich

Weale

Tumilty

et al. 2019

JHOM

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“…23 Second, several documents included stakeholder and institutional perspectives. 13,14,16,17,20,21,23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] This was noted as being important for providing participants an opportunity to grasp the complexities of multi-faceted issues 20,42 by highlighting views and experiences from experts, affected patients, community members, healthcare providers and policymakers. Several documents highlighted the importance of providing diversity and balance in perspectives.…”

Section: Sources Of Information and Approaches To Synthesismentioning

confidence: 99%

“…First, information was organized by describing the perspective, stance, or preferred policy option of each stakeholder as well as their reasoning. 17,20,21,[23][24][25][26][27]35,36,38,39,41,42,47,48 Second, evidence was organized by demonstrating how experts in different disciplines (e.g. epidemiology, policy, religion) understand the issue(s) being discussed.…”

Section: Organization Of Informationmentioning

confidence: 99%

Identifying approaches for synthesizing and summarizing information to support informed citizen deliberations in health policy: a scoping review

Wilson

Nidumolu

Berditchevskaia

et al. 2019

J Health Serv Res Policy

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Objective Public deliberations are an increasingly popular tool to engage citizens in the development of health policies and programmes. However, limited research has been conducted on how to best synthesize and summarize information on health policy issues for citizens. To begin to address this gap, our aim was to map the literature on the preparation of information to support informed citizen deliberations related to health policy issues. Methods We conducted a scoping review where two reviewers screened the results of electronic database searches, grey literature searches and hand searches of organizational websites to identify empirical studies, scholarly commentaries, and publicly available organizational documents focused on synthesizing and summarizing information to inform citizen deliberation about health policy issues. Two reviewers categorized each included document according to themes/topics of deliberation, purpose of deliberation and the form of deliberation, and developed a summary of the key findings related to synthesizing and summarizing information to support informed citizen deliberations. Results There was limited reporting about whether and how information was synthesized. Evidence was typically organized based on the source used (e.g. by comparing the views of stakeholders or experts) or according to the areas that policymakers need to consider when making decisions (e.g. benefits, harms, costs and stakeholder perspectives related to policy options). Information was presented primarily through written materials (e.g. briefs and brochures), audiovisual resources (e.g. videos or presentations from stakeholders), but some interactive presentation approaches were also identified (e.g. through interactive arts-based approaches). Conclusions The choice and framing of information to inform citizen deliberations about health policy can strongly influence their understanding of a policy issue, and has the potential to impact the discussions and recommendations that emerge from deliberations. Our review confirmed that there remains a dearth of literature describing methods of the preparation of information to inform citizen deliberations about health policy issues. This highlights the need for further exploration of optimal strategies for citizen-friendly approaches to synthesizing and summarizing information for deliberations.

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“…Avoid using terminology such as ‘to be sure’, ‘to be safe’ or ‘we may as well’ for tests and treatments that are just as likely to lead to adverse events or false positives. Engage the patient and use shared decision‐making models …”

Section: The Problemmentioning

confidence: 99%

Critical thinking, curiosity and parsimony in (emergency) medicine: ‘Doing nothing’ as a quality measure?

Keijzers

2017

Emerg Medicine Australasia

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Current medical decision-making is influenced by many factors, such as competing interests, distractions, as well as fear of missing an important diagnosis. This can result in ordering tests or providing treatments that can be harmful. Unnecessary tests are more likely to lead to false positive diagnosis or incidental findings that are of uncertain clinical relevance. Estimates indicate that almost one-third of all health spending is wasteful. The 'Choosing Wisely' campaign has identified many of these wasteful tests and treatments. This perspective proposes some suggestions to focus on our critical thinking, embrace shared decision-making and stay curious about the patient we are treating. Most importantly, 'doing nothing' could be a quality indicator for EDs, and ACEM supported audits and research to develop benchmarks for certain tests and procedures in the ED are important to achieve a cultural change.

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Engaging the public in healthcare decision-making: results from a Citizens’ Jury on emergency care services

Cited by 13 publications

References 12 publications

Creating sustainable health care systems

Creating sustainable health care systems

Identifying approaches for synthesizing and summarizing information to support informed citizen deliberations in health policy: a scoping review

Critical thinking, curiosity and parsimony in (emergency) medicine: ‘Doing nothing’ as a quality measure?

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